Staphylococcus aureus nasal colonization among pediatric cystic fibrosis patients and their household contacts

Anne Stone, Lynne Quittell, Juyan Zhou, Luis Alba, Meera Bhat, Joan Decelie-Germana, Sujatha Rajan, Lynn Bonitz, John J. Welter, Allen J. Dozor, Ingrid Gherson, Franklin D. Lowy, Lisa Saiman

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Little is known about the prevalence of Staphylococcus aureus nasal colonization and the epidemiology of methicillin-susceptible and methicillin-resistant S. aureus (MRSA) among cystic fibrosis (CF) patients and their household members. Objectives: We sought to determine the epidemiology of S. aureus among children and adolescents with CF and their household members. Methods: Three CF centers enrolled case subjects with at least 1 MRSA-positive respiratory tract culture from 2001 to 2006 and control subjects with MRSA-negative cultures. S. aureus isolates from the anterior nares of CF subjects and their household members were assessed for staphylococcal chromosomal cassette (SCC) mec type. Strain similarity was determined by pulsed-field gel electrophoresis. Results: S. aureus nasal colonization occurred in 52.4% (22/42), 27.0% (17/63), and 25.0% (72/288) of case, control, and household participants, respectively. Case subjects and their contacts were more likely to harbor MRSA in their nares and be from a multipatient CF family. Of 31 MRSA strains, 10 (32.3%) were SCCmec type IVa, associated with community-acquisition. Overall, 27.6% of 98 households had ≥2 members colonized with closely related isolates. Household members were equally likely to be colonized with closely related strains of MRSA (20/31, 65%) versus MSSA (38/80, 48%). Conclusions: This study demonstrated that household members of CF children harbor both MSSA and MRSA, including CA-MRSA, and that S. aureus is transmitted within CF households. Carriage of S. aureus by household members of CF children may have implications for infection control and treatment strategies. Future studies should monitor the distribution and virulence of SCCmecA types in patients with CF.

Original languageEnglish (US)
Pages (from-to)895-899
Number of pages5
JournalPediatric Infectious Disease Journal
Volume28
Issue number10
DOIs
StatePublished - Jan 1 2009
Externally publishedYes

Fingerprint

Nose
Cystic Fibrosis
Methicillin-Resistant Staphylococcus aureus
Staphylococcus aureus
Pediatrics
Epidemiology
Methicillin
Pulsed Field Gel Electrophoresis
Infection Control
Respiratory System
Virulence

Keywords

  • Adolescent
  • Infection
  • Molecular
  • Respiratory tract
  • Transmission

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Staphylococcus aureus nasal colonization among pediatric cystic fibrosis patients and their household contacts. / Stone, Anne; Quittell, Lynne; Zhou, Juyan; Alba, Luis; Bhat, Meera; Decelie-Germana, Joan; Rajan, Sujatha; Bonitz, Lynn; Welter, John J.; Dozor, Allen J.; Gherson, Ingrid; Lowy, Franklin D.; Saiman, Lisa.

In: Pediatric Infectious Disease Journal, Vol. 28, No. 10, 01.01.2009, p. 895-899.

Research output: Contribution to journalArticle

Stone, A, Quittell, L, Zhou, J, Alba, L, Bhat, M, Decelie-Germana, J, Rajan, S, Bonitz, L, Welter, JJ, Dozor, AJ, Gherson, I, Lowy, FD & Saiman, L 2009, 'Staphylococcus aureus nasal colonization among pediatric cystic fibrosis patients and their household contacts', Pediatric Infectious Disease Journal, vol. 28, no. 10, pp. 895-899. https://doi.org/10.1097/INF.0b013e3181a3ad0a
Stone, Anne ; Quittell, Lynne ; Zhou, Juyan ; Alba, Luis ; Bhat, Meera ; Decelie-Germana, Joan ; Rajan, Sujatha ; Bonitz, Lynn ; Welter, John J. ; Dozor, Allen J. ; Gherson, Ingrid ; Lowy, Franklin D. ; Saiman, Lisa. / Staphylococcus aureus nasal colonization among pediatric cystic fibrosis patients and their household contacts. In: Pediatric Infectious Disease Journal. 2009 ; Vol. 28, No. 10. pp. 895-899.
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abstract = "Background: Little is known about the prevalence of Staphylococcus aureus nasal colonization and the epidemiology of methicillin-susceptible and methicillin-resistant S. aureus (MRSA) among cystic fibrosis (CF) patients and their household members. Objectives: We sought to determine the epidemiology of S. aureus among children and adolescents with CF and their household members. Methods: Three CF centers enrolled case subjects with at least 1 MRSA-positive respiratory tract culture from 2001 to 2006 and control subjects with MRSA-negative cultures. S. aureus isolates from the anterior nares of CF subjects and their household members were assessed for staphylococcal chromosomal cassette (SCC) mec type. Strain similarity was determined by pulsed-field gel electrophoresis. Results: S. aureus nasal colonization occurred in 52.4{\%} (22/42), 27.0{\%} (17/63), and 25.0{\%} (72/288) of case, control, and household participants, respectively. Case subjects and their contacts were more likely to harbor MRSA in their nares and be from a multipatient CF family. Of 31 MRSA strains, 10 (32.3{\%}) were SCCmec type IVa, associated with community-acquisition. Overall, 27.6{\%} of 98 households had ≥2 members colonized with closely related isolates. Household members were equally likely to be colonized with closely related strains of MRSA (20/31, 65{\%}) versus MSSA (38/80, 48{\%}). Conclusions: This study demonstrated that household members of CF children harbor both MSSA and MRSA, including CA-MRSA, and that S. aureus is transmitted within CF households. Carriage of S. aureus by household members of CF children may have implications for infection control and treatment strategies. Future studies should monitor the distribution and virulence of SCCmecA types in patients with CF.",
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AU - Quittell, Lynne

AU - Zhou, Juyan

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AU - Decelie-Germana, Joan

AU - Rajan, Sujatha

AU - Bonitz, Lynn

AU - Welter, John J.

AU - Dozor, Allen J.

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N2 - Background: Little is known about the prevalence of Staphylococcus aureus nasal colonization and the epidemiology of methicillin-susceptible and methicillin-resistant S. aureus (MRSA) among cystic fibrosis (CF) patients and their household members. Objectives: We sought to determine the epidemiology of S. aureus among children and adolescents with CF and their household members. Methods: Three CF centers enrolled case subjects with at least 1 MRSA-positive respiratory tract culture from 2001 to 2006 and control subjects with MRSA-negative cultures. S. aureus isolates from the anterior nares of CF subjects and their household members were assessed for staphylococcal chromosomal cassette (SCC) mec type. Strain similarity was determined by pulsed-field gel electrophoresis. Results: S. aureus nasal colonization occurred in 52.4% (22/42), 27.0% (17/63), and 25.0% (72/288) of case, control, and household participants, respectively. Case subjects and their contacts were more likely to harbor MRSA in their nares and be from a multipatient CF family. Of 31 MRSA strains, 10 (32.3%) were SCCmec type IVa, associated with community-acquisition. Overall, 27.6% of 98 households had ≥2 members colonized with closely related isolates. Household members were equally likely to be colonized with closely related strains of MRSA (20/31, 65%) versus MSSA (38/80, 48%). Conclusions: This study demonstrated that household members of CF children harbor both MSSA and MRSA, including CA-MRSA, and that S. aureus is transmitted within CF households. Carriage of S. aureus by household members of CF children may have implications for infection control and treatment strategies. Future studies should monitor the distribution and virulence of SCCmecA types in patients with CF.

AB - Background: Little is known about the prevalence of Staphylococcus aureus nasal colonization and the epidemiology of methicillin-susceptible and methicillin-resistant S. aureus (MRSA) among cystic fibrosis (CF) patients and their household members. Objectives: We sought to determine the epidemiology of S. aureus among children and adolescents with CF and their household members. Methods: Three CF centers enrolled case subjects with at least 1 MRSA-positive respiratory tract culture from 2001 to 2006 and control subjects with MRSA-negative cultures. S. aureus isolates from the anterior nares of CF subjects and their household members were assessed for staphylococcal chromosomal cassette (SCC) mec type. Strain similarity was determined by pulsed-field gel electrophoresis. Results: S. aureus nasal colonization occurred in 52.4% (22/42), 27.0% (17/63), and 25.0% (72/288) of case, control, and household participants, respectively. Case subjects and their contacts were more likely to harbor MRSA in their nares and be from a multipatient CF family. Of 31 MRSA strains, 10 (32.3%) were SCCmec type IVa, associated with community-acquisition. Overall, 27.6% of 98 households had ≥2 members colonized with closely related isolates. Household members were equally likely to be colonized with closely related strains of MRSA (20/31, 65%) versus MSSA (38/80, 48%). Conclusions: This study demonstrated that household members of CF children harbor both MSSA and MRSA, including CA-MRSA, and that S. aureus is transmitted within CF households. Carriage of S. aureus by household members of CF children may have implications for infection control and treatment strategies. Future studies should monitor the distribution and virulence of SCCmecA types in patients with CF.

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